United States 117th Congress Status: Died 1 D cosponsors

HR 8890 — Physician Wellness Program Act of 2022

Last action — Referred to the Subcommittee on Health.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. Died in session

This bill died with 117th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Physician Wellness Program Act of 2022 This bill exempts wellness programs that provide certain mental or behavioral health services for physicians from restrictions under the Stark law (i.e., the Physician Self-Referral Law) and federal anti-kickback laws.

Bill Text

Sections of law this bill changes

2 sections in 1 law

From the bill's own amending language, matched to the official United States Code (current through Public Law 119-124).

Social security · 42 U.S.C. ch. 7 2 sections
  • § 1320a-7b Criminal penalties for acts involving Federal health care programs Amends

    42 U.S.C. § 1320a-7b — at 1320a-7b(b)(3)

    The law today

    (a) Making or causing to be made false statements or representations Whoever— (1) knowingly and willfully makes or causes to be made any false statement or representation of a material fact in any application for any benefit or payment under a Federal health care program (as defined in subsection (f)), (2) at any time knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining rights to such benefit or payment, (3) having knowledge of the occurrence of any event affecting (A) his initial or continued right to any such benefit or payment, or (B) the initial or continued right to any such benefit or payment of any other individual in whose behalf he has applied for or is receiving such benefit or payment, conceals or fails to disclose such event with an intent fraudulently to secure such benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized, (4) having made application to receive any such benefit or payment for the use and benefit of another and having received it, knowingly and willfully converts such benefit or payment or any part thereof to a use other than for the use and benefit of such other person, (5) presents or causes to be presented a claim for a physician’s service for which payment may be made under a Federal health care program and knows that the individual who furnished the service was not licensed as a physician, or (6) for a fee knowingly and willfully counsels or assists an individual to dispose of assets (including by any transfer in trust) in order for the individual to become eligible for medical assistance under a State plan under subchapter XIX, if disposing of the assets results in the imposition of a period of ineligibility for such assistance under section 1396p(c) of this title, shall (i) in the case of such a statement, representation, concealment, failure, or conversion by any person in connection with the furnishing (by that person) of items or services for which payment is or may be made under the program, be guilty of a felony and upon conviction thereof fined not more than $100,000 or imprisoned for not more than 10 years or both, or (ii) in the case of such a statement, representation, concealment, failure, conversion, or provision of counsel or assistance by any other person, be guilty of a misdemeanor and upon conviction thereof fined not more than $20,000 or imprisoned for not more than one year, or both. In addition, in any case where an individual who is otherwise eligible for assistance under a Federal health care program is convicted of an offense under the preceding provisions of this subsection, the administrator of such program may at its option (notwithstanding any other provision of such program) limit, restrict, or suspend the eligibility of that individual for such period (not exceeding one year) as it deems appropriate; but the imposition of a limitation, restriction, or suspension with respect to the eligibility of any individual under this sentence shall not affect the eligibility of any other person for assistance under the plan, regardless of the relationship between that individual and such other person. (b) Illegal remunerations (1) Whoever knowingly and willfully solicits or receives any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind— (A) in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or (B) in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more tha...

    34 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

  • § 1395nn Limitation on certain physician referrals Amends

    42 U.S.C. § 1395nn — at 1395nn(e)

    The law today

    (a) Prohibition of certain referrals (1) In general Except as provided in subsection (b), if a physician (or an immediate family member of such physician) has a financial relationship with an entity specified in paragraph (2), then— (A) the physician may not make a referral to the entity for the furnishing of designated health services for which payment otherwise may be made under this subchapter, and (B) the entity may not present or cause to be presented a claim under this subchapter or bill to any individual, third party payor, or other entity for designated health services furnished pursuant to a referral prohibited under subparagraph (A). (2) Financial relationship specified For purposes of this section, a financial relationship of a physician (or an immediate family member of such physician) with an entity specified in this paragraph is— (A) except as provided in subsections (c) and (d), an ownership or investment interest in the entity, or (B) except as provided in subsection (e), a compensation arrangement (as defined in subsection (h)(1)) between the physician (or an immediate family member of such physician) and the entity. An ownership or investment interest described in subparagraph (A) may be through equity, debt, or other means and includes an interest in an entity that holds an ownership or investment interest in any entity providing the designated health service. (b) General exceptions to both ownership and compensation arrangement prohibitions Subsection (a)(1) shall not apply in the following cases: (1) Physicians’ services In the case of physicians’ services (as defined in section 1395x(q) of this title) provided personally by (or under the personal supervision of) another physician in the same group practice (as defined in subsection (h)(4)) as the referring physician. (2) In-office ancillary services In the case of services (other than durable medical equipment (excluding infusion pumps) and parenteral and enteral nutrients, equipment, and supplies)— (A) that are furnished— (i) personally by the referring physician, personally by a physician who is a member of the same group practice as the referring physician, or personally by individuals who are directly supervised by the physician or by another physician in the group practice, and (ii) (I) in a building in which the referring physician (or another physician who is a member of the same group practice) furnishes physicians’ services unrelated to the furnishing of designated health services, or (II) in the case of a referring physician who is a member of a group practice, in another building which is used by the group practice— (aa) for the provision of some or all of the group’s clinical laboratory services, or (bb) for the centralized provision of the group’s designated health services (other than clinical laboratory services),  unless the Secretary determines other terms and conditions under which the provision of such services does not present a risk of program or patient abuse, and (B) that are billed by the physician performing or supervising the services, by a group practice of which such physician is a member under a billing number assigned to the group practice, or by an entity that is wholly owned by such physician or such group practice, if the ownership or investment interest in such services meets such other requirements as the Secretary may impose by regulation as needed to protect against program or patient abuse. Such requirements shall, with respect to magnetic resonance imaging, computed tomography, positron emission tomography, and any other designated health services specified under subsection (h)(6)(D) that the Secretary determines appropriate, include a requirement that the referring physician inform the individual in writing at the time of the referral that the individual may obtain the services for which the individual is being referred from a person other than a person described in subparagraph (A)(i) and provide such individual...

    33 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

How this bill changes current law

2 changes Share ↗

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill establishes exceptions for physician wellness programs under the Social Security Act.

  • 42 U.S.C. 1395nn(e)

    (9) Physician wellness programs.--A bona fide mental health or behavioral health improvement or maintenance program offered to a physician by an entity, if-- (A) such program-- (i) consists of counseling, mental health services, a suicide prevention program, or a substance use disorder prevention and treatment program; (ii) is made available to a physician for the primary purpose of preventing suicide, improving mental health and resiliency, or providing training in appropriate strategies to promote the mental health and resiliency of such physician; (iii) is set out in a written policy, approved in advance of the operation of the program by the governing body of the entity providing such program, that includes-- (I) a description of the content and duration of the program; (II) a description of the evidence-based support for the design of the program; (III) the estimated cost of the program; (IV) the personnel (including the qualifications of such personnel) implementing the program; and (V) the method by which such entity will evaluate the use and success of the program; (iv) is offered by an entity with a formal medical staff to all physicians who practice in the geographic area served by such entity, including physicians who hold bona fide appointments to the medical staff of such entity or otherwise have clinical privileges at such entity; (v) is offered to all such physicians on the same terms and conditions and without regard to the volume or value of referrals or other business generated by a physician for such entity; (vi) is evidence-based and conducted by a qualified health professional; and (vii) meets such other requirements the Secretary may impose by regulation as needed to protect against program or patient abuse; (B) such entity is-- (i) a hospital; (ii) an ambulatory surgical center; (iii) a community health center; (iv) a rural emergency hospital; (v) a rural health clinic; (vi) a skilled nursing facility; or (vii) a similar entity, as determined by the Secretary; (C) neither the provision of such program, nor the value of such program, are contingent upon the number or value of referrals made by a physician to such entity.

    This change introduces a defined exception for wellness programs aimed at improving the mental health of physicians, which had not been explicitly recognized in prior law.

  • 42 U.S.C. 1320a-7b(b)(3)

    in subparagraph (J), by striking "and" at the end; in subparagraph (K), by striking the period at the end and inserting "; and"; → (L) a bona fide mental health or behavioral health improvement or maintenance program, if-- (i) such program-- (I) consists of counseling, mental health services, a suicide prevention program, or a substance use disorder prevention and treatment program; (II) is made available to a physician and other clinicians for the primary purpose of preventing suicide, improving mental health and resiliency, or providing training in appropriate strategies to promote the mental health and resiliency of such physician; (III) is set out in a written policy, approved in advance of the operation of the program by the governing body of the entity providing such program, that includes-- (aa) a description of the content and duration of the program; (bb) a description of the evidence-based support for the design of the program; (cc) the estimated cost of the program; (dd) the personnel (including the qualifications of such personnel) implementing the program; and (ee) the method by which such entity will evaluate the use and success of the program; (IV) is offered by an entity with a formal medical staff to all physicians and other clinicians who practice in the geographic area served by such entity, including physicians who hold bona fide appointments to the medical staff of such entity or otherwise have clinical privileges at such entity; (V) is offered to all such physicians and clinicians on the same terms and conditions and without regard to the volume or value of referrals or other business generated by a physician or clinician for such entity; (VI) is evidence-based and conducted by a qualified health professional; and (VII) meets such other requirements the Secretary may impose by regulation as needed to protect against program or patient abuse; (ii) such entity is-- (I) a hospital; (II) an ambulatory surgical center; (III) a community health center; (IV) a rural emergency hospital; (V) a skilled nursing facility; or (VI) any similar entity, as determined by the Secretary; (iii) neither the provision of such program, nor the value of such program, are contingent upon the number or value of referrals made by a physician or other clinician to such entity.

    This amendment creates a new exception under the Anti-Kickback Statute for wellness programs aimed at improving mental health and resiliency among healthcare providers.

Action History

  1. Referred to the Subcommittee on Health.

  2. Introduced in House

  3. Introduced in House

  4. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  5. Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 546 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (546)

546 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare labor
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HR 8890 do?
Physician Wellness Program Act of 2022 This bill exempts wellness programs that provide certain mental or behavioral health services for physicians from restrictions under the Stark law (i.e., the Physician Self-Referral Law) and federal anti-kickback laws.
Who sponsors HR 8890?
HR 8890 is sponsored by Ruiz, Raul (Democratic).
What is the current status of HR 8890?
This bill died with 117th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HR 8890?
Track HR 8890 free on One Click Politics — get push/email alerts when it moves.

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